IMPROVE the Moment

With DBT

Click here to watch the video

• IMPROVE represents a repertoire of coping skills. These skills are

ways to make a bad situation better.
– Imagery refers to guided visualizations. This can include
visualizing a coping skill when you can’t use it physically.
– Meaning refers to finding purpose in a difficult situation.
– Prayer refers to any form of spiritual or religious coping.
– Relaxation refers to a quieting of the entire body.
– One thing at a time refers to making a list of items and focusing
on one item at a time.
– Vacation refers to taking a break and engaging in self-care until
you are ready to face the situation.
– Encouragement refers to providing self-validation.

Kirby Reutter, Ph.D.

1
Greetings, and welcome to the eighth video in this module. So far in this series on distress
tolerance, we have learned a wide repertoire of coping skills and coping mindsets. In this lesson,
we will learn another series of coping skills which follow the acronym IMPROVE. So, let’s get
started.

The IMPROVE acronym represents another repertoire of possible coping skills. Each of the
IMPROVE skills refers to a specific way to make a bad situation better or, at the very least, less
bad.

The IMPROVE acronym stands for Imagery, Meaning, Prayer, Relaxation, One thing at a time,
Vacation, and Encouragement. IMPROVE is not just an acronym, it’s also a metaphor. Each of these
elements represents specific ways to take a crisis situation and find a way to improve it. This time
let’s start at the bottom and work our way up.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

2
Let’s start off talking about the Encouragement skill. Encouragement refers to teaching our clients
how to become their own best self-validators. If you remember from previous videos, people who
have been traumatized have also been invalidated. Why is that?

That is because trauma is invalidating but invalidation is also traumatizing. By definition, if you’re
working with someone who has been traumatized, they’ve also been invalidated. And what that
means is when one of our traumatized clients has experienced a crisis situation, they will rarely
find enough external validation that they need and crave to help them through that crisis
situation. In other words, what they need to learn to do is to become their own best self-
validators.

References

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

3
The Vacation skill refers to taking a temporary break from whatever situation you’re in that’s
causing you lots of distress, and intentionally engaging in some sort of self-care until you are
ready to re-engage in the situation.

That might mean take a walk. It might mean go out to eat. Obviously, this will be different for
different people. For some people, it might be do some shopping, although that can also be very
self-destructive and dangerous, so be careful with that one.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

4
One thing at a time, that’s the skill to use when clients are just overwhelmed with so many things
that need to be done, so many problems, commitments, deadlines, and they don’t even know
where to start.

So where do you start? Well, One thing at a time refers to making a list, prioritizing, and then
focusing on just one item at a time.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

5
Relaxation refers to an intentional quieting of the entire body, in other words, activation of the
parasympathetic nervous system. Relaxation refers to doing something that will directly and
automatically have an immediate relaxing effect on your whole body.

And once again, that will be different for different people. For one person, that might be
gardening. For another person, that might be a bubble bath. For another person, that might be a
deep body massage.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

6
Prayer refers to meditation or connection with a higher power, or really any form of spiritual and
religious coping.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

7
The Meaning skill refers to finding purpose in a difficult situation. Think of it this way. Pain without
purpose leads to suffering. When we go through tough times, but we can identify some kind of
purpose or meaning for why we went through what we did, that pain becomes much more
bearable, much more manageable.

But when we experience something, and we cannot find any reason for why we went through it,
now that pain becomes unbearable. In other words, it becomes suffering.

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

8
So the Meaning skill is all about learning to teach our clients to ask some of those deep
philosophical, or existential, or maybe theological questions based on your client’s particular belief
system or value system. For example, what can I learn from this situation that I could not have
learned otherwise? Or, how can this situation be redeemed or transformed into something
positive? Or, instead of letting this situation paralyze my life, how can this situation instead
inspire me and motivate me or mobilize me, or maybe other people too? Or how can I use this
experience to benefit humanity or leave the world a better place? Or does God have a plan for the
situation? What is that plan? What is He trying to teach me?

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

9
And the last skill, it’s actually the first skill since we’re going backwards, is Imagery. Imagery
refers to guided visualization such as The safe place exercise, the container exercise, or ride the
wave, which we’ve covered in other videos. There are many ways to engage in guided visualization
as a coping strategy.

References

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

10
However, Imagery can also refer to visualizing a specific coping skill, especially if you cannot
physically do it in the moment. Let’s just be realistic. We cannot always cope with a specific
coping strategy in the moment. So, the next best option is to visualize using that coping strategy.

For example, the Vacation skill that we just talked about. Maybe you can’t take a quick break right
in this moment. But can you visualize it? Or the Relaxation skill we just talked about, maybe you
can’t do that relaxing activity that you would like to do. But can you at least visualize it, etc.?

References

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Reutter, K. (2019). The dialectical behavior therapy skills workbook for PTSD: Practical exercises
for overcoming trauma and post-traumatic stress disorder (1st ed.). New Harbinger Publications.

11
Okay. Once again, we’ve covered a lot of ground here, so let’s summarize what we just learned.
The IMPROVE acronym represents another repertoire of possible coping skills. Each of the
IMPROVE skills refers to a specific way of making a bad situation better or, at the very least, less
bad.

12
Imagery refers to guided visualization, such as the safe place, ride the wave, or container
exercises. But Imagery also refers to visualizing a specific coping skill when you cannot physically
use it in the moment.

Meaning refers to finding purpose in a difficult situation.

13
Prayer refers to meditation, connection with a higher power, or any form of spiritual or religious
coping. Relaxation refers to an intentional quieting of the entire body. One thing at a time refers to
making a list, prioritizing, and then focusing on only one item at a time.

14
Vacation refers to taking a break and engaging in self-care until you are ready to face the
situation. And Encouragement refers to providing yourself with self-validation, especially in the
absence of external validation.

15